The purpose of this renewal application is to extend our comprehensive assessment of the mental health, social functioning and neuropsychological performance of workers occupationally exposed to lead. In the fall of 1981 we initiated an epidemiologic study into the effects of cumulative and current lead exposure using a cross-sectional design in which lead workers and non-exposed controls were assessed with a neuropsychological test battery, sections of the Diagnostic Interview Schedule, a detailed social functioning inventory, and an occupational history questionnaire. Biological measures of past and current lead exposure and recent alcohol and drug use are also obtained. A major goal of the renewal application is to complete the analysis of these data. The ultimate aim of our research is to provide data that may be useful in the prevention of mental health problems resulting from lead exposure. In the course of conducting our pilot study, a striking association was observed between elevated current blood lead levels and deficits in performance on the neuropsychological tests. In this application, we propose to systematically ascertain the acute effects of high lead exposure and the recovery of functioning following the decline in blood lead levels associated with removal from exposure. Development of a comprehensive prevention program also requires knowledge of the natural history of a disorder. The time course for the development of neuropsychological deficits and deterioration in psychosocial functioning in relation to duration and intensity of lead exposure is not known. Therefore, we wish to initiate a prospective study of the natural history of neuropsychological and psychosocial changes in lead workers. We also propose to verify psychosocial information by interviewing a significant other adult.